吃喜保宁多久起效果

How long does it take for Vigabatrin to take effect?

After taking the tablet, peak blood concentration is reached within 1-2.5 hours, and the effect lasts for several days. It may take about one to two weeks to tell if it stops infantile spasms, and it may take several weeks to stop them. Usually there is no definite value for how long it will take for a patient to take the medicine before it will take effect. The patient's condition and constitution are different, and the time for the effect to take effect is also different. Patients are monitored for 14 to 18 weeks (including the time it takes to reach a prescribed dose) to see if Vigabatrin is effective for them.

In a multicenter, open-label, randomized trial, 102 hospitals enrolled infants with clinical diagnoses of infantile spasms and hyperrhythmic (or similar) EEG within 7 days before enrollment. Participants were randomly assigned (1:1) by a secure website to receive treatment with Vigabatrin or hormone therapy alone.

The lowest dose is prednisolone 10 mg 4 times daily, or butylide 0.5 mg (40 IU) intramuscularly on alternate days, 100 mg/kg daily with or without vigabatrin. The primary outcome was cessation of convulsions, defined as the absence of convulsions between days 14 and 42 after trial entry, based on parent and caregiver records in the seizure diary.

Results: 766 infants were screened, of whom 377 were randomly assigned to hormone therapy with Vigabatrin (186) or hormone therapy alone (191). The primary outcome was assessed for all 377 infants.

Between days 14 and 42 inclusive, 133 of 186 patients (72%) who received vigabatrin hormonal therapy did not experience cramps, compared with 108 of 191 patients (57%) who received hormonal therapy alone (difference 15.0%, 95% CI 5.1-24.9, p=0.002).

Thirty-three infants experienced serious adverse reactions requiring hospitalization (16 infants received hormone therapy alone and 17 infants received verabatrine hormone therapy). The most common severity was infection, with 5 infants receiving hormone therapy alone and 4 infants receiving vigabatrin. There were no deaths attributable to treatment.

Conclusions: Hormone therapy with Vigabatrin is more effective in preventing infantile spasms than hormonal therapy alone.

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References

O'Callaghan FJ, Edwards SW, Alber FD, Hancock E, Johnson AL, Kennedy CR, Likeman M, Lux AL, Mackay M, Mallick AA, Newton RW, Nolan M, Pressler R, Rating D, Schmitt B, Verity CM, Osborne JP; participating investigators. Safety and effectiveness of hormonal treatment versus hormonal treatment with vigabatrin for infantile spasms (ICISS): a randomized, multicentre, open-label trial. Lancet Neurol. 2017 Jan;16(1):33-42. doi: 10.1016/S1474-4422(16)30294-0. Epub 2016 Nov 10. PMID: 27838190.